tumor conferencing tools for regional collaborative cancer care using the next generation internet
DESCRIPTION
Tumor Conferencing Tools for Regional Collaborative Cancer Care Using the Next Generation Internet. Brent K. Stewart, PhD, DABMP Professor of Radiology, Bioengineering and Medical Education Director of Imaging Informatics and Diagnostic Physics University of Washington School of Medicine - PowerPoint PPT PresentationTRANSCRIPT
Tumor Conferencing Tools for Regional Collaborative Cancer Care Using the
Next Generation Internet
Brent K. Stewart, PhD, DABMPBrent K. Stewart, PhD, DABMP
Professor of Radiology, Bioengineering and Medical EducationProfessor of Radiology, Bioengineering and Medical EducationDirector of Imaging Informatics and Diagnostic PhysicsDirector of Imaging Informatics and Diagnostic Physics
University of Washington School of MedicineUniversity of Washington School of MedicineDepartment of Radiology, 357115Department of Radiology, 357115
Seattle, WA 98195Seattle, WA [email protected]@u.washington.edu
What Have We Done?What Have We Done?
• Design, construction and evaluation of collaborative Design, construction and evaluation of collaborative Internet tools providing effective, distributed tumor board Internet tools providing effective, distributed tumor board conferencing among multiple sites of practice conferencing among multiple sites of practice
• Web accessible info. system that can upload (case Web accessible info. system that can upload (case preparation), store, and display (case presentation) clinical preparation), store, and display (case presentation) clinical images, video, graphics, documents, URLs, and protocolsimages, video, graphics, documents, URLs, and protocols
• Web browser visuals and interactions trans. to all sitesWeb browser visuals and interactions trans. to all sites• The Web browser in parallel with IP videoconferencingThe Web browser in parallel with IP videoconferencing• Both channels use high-bright/contrast LCD projectorsBoth channels use high-bright/contrast LCD projectors• Special attention to sound quality requiredSpecial attention to sound quality required• Retrospective reference or clinical mgmt purposesRetrospective reference or clinical mgmt purposes
Preparation Before a Preparation Before a ConferenceConference
Enter patient information in the database through the web and schedule them to the conference.
Upload patient studies that are to be shown and sequence.
Schedule a new conference.
Presentation Presentation During a During a
ConferenceConference
Information Objects Information Objects Typically Presented at a Typically Presented at a
ConferenceConference
Why Have We Done It?Why Have We Done It?
• Seattle Cancer Care AllianceSeattle Cancer Care Alliance• University of Washington Medical CenterUniversity of Washington Medical Center• Childrens Hospital and Regional Medical CenterChildrens Hospital and Regional Medical Center• Fred Hutchinson Cancer Research CenterFred Hutchinson Cancer Research Center• Southeast Lake Union (SELU) Outpatient CenterSoutheast Lake Union (SELU) Outpatient Center
• January 29, 2001: all outpatient adult oncology services January 29, 2001: all outpatient adult oncology services move to SELU – inpatient/outpatient oncologists splitmove to SELU – inpatient/outpatient oncologists split
• Tumor conferences important in oncology patient mgmt.Tumor conferences important in oncology patient mgmt.• Requires a gathering of multidisciplinary expertsRequires a gathering of multidisciplinary experts• Relative advantages/disadvantages of treatment alternativesRelative advantages/disadvantages of treatment alternatives• Collegial atmosphere – a place for networking and learningCollegial atmosphere – a place for networking and learning
• Hypothesis: more frequent expert participationHypothesis: more frequent expert participation
CCA - Geographical DistributionCCA - Geographical Distribution
UWMCUWMC
CHRMCCHRMC
FHCRCFHCRCSELUSELU
GigapopGigapop
How Have We Done It?How Have We Done It?
• NLM Phase 2 award: Biomedical Applications of the NGINLM Phase 2 award: Biomedical Applications of the NGI• Univ. of Washington participant in Internet2 and NGIUniv. of Washington participant in Internet2 and NGI• UW created the Pacific Northwest GigapopUW created the Pacific Northwest Gigapop• PNWGP connects the SCCA partners with 2.5 or 10 GbpsPNWGP connects the SCCA partners with 2.5 or 10 Gbps• Three investigational groups formedThree investigational groups formed• Apache w/128-bit SSL encryption, Debian Linux, MySQLApache w/128-bit SSL encryption, Debian Linux, MySQL• Programming: server – PHP4; client - HTML/JavaScript Programming: server – PHP4; client - HTML/JavaScript • Digital connectivity to path. slide and radiology imagesDigital connectivity to path. slide and radiology images• eSQL query connectivity with the UWAMC EMReSQL query connectivity with the UWAMC EMR• Three tiered security infrastructure (authentic./authoriz.)Three tiered security infrastructure (authentic./authoriz.)
Seattle Cancer Care Alliance NetworkSeattle Cancer Care Alliance Network
Fred HutchinsonCancer Research Center
University of Washington
Internet
ExternalPartner
Childrens Hospital andRegional Medical Center
PNW Gigapop
OC-192, 10 Gbps
OC-48, 2.4 GbpsSeattle Cancer Care Alliance
(SCCA/SELU)
Three TeamsThree Teams
• Contextual Inquiry/Contextual Design TeamContextual Inquiry/Contextual Design Team• Cultural anthropology (observations, interviews, coding)Cultural anthropology (observations, interviews, coding)• Design requirements, simulation scenarios and usability testingDesign requirements, simulation scenarios and usability testing• EvaluationEvaluation
• Technical Infrastructure TeamTechnical Infrastructure Team• Collaborative tool developmentCollaborative tool development• Synthesis of existing on-line clinical information resources (e.g., Synthesis of existing on-line clinical information resources (e.g.,
MIND/MINDscape and PACS images) into developed toolsMIND/MINDscape and PACS images) into developed tools• Medical data privacy and security, network QoSMedical data privacy and security, network QoS
• Telepresence (Folie Telepresence (Folie áá Deux) Team Deux) Team• Our advanced R&D team (augmented reality, immersion, etc. )Our advanced R&D team (augmented reality, immersion, etc. )• Technologies for human interfaces and collaborationTechnologies for human interfaces and collaboration
Conference AttendanceConference Attendance
FerndaleBellinghamAnacortes
Sedro WooleyArlingtonMarysville
Darrington
EverettForks PortAngeles Port
Townsend
Shelton
BremertonEastGraysHarbor
Aberdeen
ShoalwaterBay
CathlametWahkiakum
County
MasonCounty
VancouverWhiteSalmon Goldendale
ToppenishEast LewisCounty
AuburnSnoqualmie Wenatchee
EphrataQuincy
OthelloOdessaCle Elum
EllensburgYakimaWapato
Grandview Dayton
OrovilleTonasket
Omak
GrandCoulee
RepublicNorthPendOreilleCountyChewelah
Newport
Colville
Orcas IslandFriday Harbor
Island CountyOak Harbor
OlympiaMadiganUS Army
Tacoma
Spokane
RitzvilleColfax
Pullman
Carnation
SouthBeach FamFam
FamFam
FamFam
FamFam
FamFam
Ob/GOb/G
FamFam
IntMdIntMd
XFamFam
IntMdIntMdOb/GOb/GPedsPeds
FamFamIntMdIntMdPsychPsych
FamFamOb/GOb/GPedsPeds
2 xFamFamOb/GOb/GPedsPeds
XA
A
FaFam m
FaFam m
FaFam m
FaFam m
7 xSeattle
FaFam m
Bozeman
Great Falls
Lolo
Superior
RonanLibby
WhitefishColumbia
Falls
Browning
Cut Bank
Shelby
Conrad
Choteau
Chester Havre Harlem
St. Ignatius
Helena
PhillipsburgHamilton
DeerLodge
Dillon
Sheridan
Ennis
ThreeForks
Livingston
Red Lodge
Big Timber
Harlowton
Columbus
Roundup
Lewiston
Glasgow
Plentywood
Culbertson
Sidney
Wolf Point
Glendive
BakerMiles City
FamFam
PedsPedsFamFam
FamFam
IntMdIntMdMissoula
XBillings
IntMdIntMdFamFam
FamFam
A
SandPoint
PinehurstSaint
Maries
Moscow
Troy
Grangeville
McCall
Salmon
RigbyRexburg
DriggsHailey
Mountain Home
Twin Falls
JeromeWendell
ShoshoneRupert
Malad CityPreston
Montpelier
Blackfoot PocatelloAmerican
Falls
Council
Emmett
Caldwell
Nampa
BoiseFamFam
IntMdIntMdOb/GOb/GPsychPsychSurgSurg
IntMdIntMdFamFam
Orofino
FamFamXFamFamPedsPeds
AFairbanks
Juneau
Ketchikan
Kodiak Island
Kotzebue
Metlakatla
PetersburgWrangell
Sitka
HainesCordova
Glenallen
Seward
ValdezPalmer
Wasilla
KenaiSoldotnaHomer
FamFam
AnchorageFamFamOb/GOb/GPsychPsych
FamFam(planned)
A
Note: Alaska not to scale
U N I V E R S I T Y O F W A S H I N G T O N S C H O O L O F M E D I C I N E
WAMI Program Site Maps
Residency SitesResidency Sites
IntMdIntMd
PsychPsych
FamFam Family PracticeInternal MedicinePsychiatry
Clerkship SitesClerkship Sites
PedsPeds
Family MedicineInternal MedicineOb/GynecologyPediatricsPsychiatrySurgery
PsychPsych
SurgSurg
FamFam
IntMdIntMd
Ob/GOb/G
FaFa m m indicates presence ofboth Family MedicineClerkship and FamilyPractice Residency
WAMI FirstYear Sites
CommunityHealth ServicesDevelopmentSites (CHSD)Rural / UnderservedOpportunitiesProgram PreceptorSites (R/UOP)
Area HealthEducation CenterSites (AHEC)
A
indicates presenceof both CHSD and RUOP
LEGEND
Laramie
Cheyenne
Casper
FamFam
FamFamA
A
Rawlins
Newcastle
Greybull/ Basin Sheridan
Torrington
Green River
Thermopolis
Biomedical Applications of the NGI - Phase 3Biomedical Applications of the NGI - Phase 3
• Vision: extend infrastructure/tools from Phase 2 to demon. Vision: extend infrastructure/tools from Phase 2 to demon. with SCCA affiliates throughout broader multi-state regionwith SCCA affiliates throughout broader multi-state region
• Treat the resultant ‘product’ of Phase 2 as a clinical trial in Treat the resultant ‘product’ of Phase 2 as a clinical trial in Phase 3 (IOM global telemedicine evaluation framework)Phase 3 (IOM global telemedicine evaluation framework)
• Use of multicast capabilities for conferencing “n” sitesUse of multicast capabilities for conferencing “n” sites
• Multi-resolution and multi-rate solutionsMulti-resolution and multi-rate solutions
• Tx info. from referring instit. for conference/patient mgmtTx info. from referring instit. for conference/patient mgmt
• How effective at providing a collaborative environment?How effective at providing a collaborative environment?